DBT Series 8 - TIPP

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Onward and upward to our next DBT Distress Tolerance skill! Reminder about the goal of Distress Tolerance skills: crisis survival (1). The next skill we will learn about is called TIPP (sometimes you’ll see it written as TIP).

The TIPP skills can be utilized when you are feeling high intensity emotions (think 9 or 10 out of 10 on the intensity scale). When you are experiencing these intense emotions, they can contribute to you not thinking straight and/or not moving forward effectively. The TIPP skills can help with these high intensity emotions quickly by reducing the heightened physiological state in the body.

TIPP is an acronym that stands for:

  • Temperature
  • Intense Exercise (or Movement)
  • Paced Breathing
  • Paired Muscle Relaxation

T - Temperature refers to exposing the body to cold water to help bring the body temperature down and to kick on the Parasympathetic Nervous System. To do this, you can submerge your face in a bowl of ice cold water for at least 30 seconds. If you don’t have access to a bowl of water, you can alternatively hold a bag full of ice up to your eyes, temples, and cheeks while hinging at the hips and holding your breath for at least 30 seconds. This helps our heart decrease (in a good way!).

**Special note: if you have any heart conditions or are taking any medications (i.e., beta blockers), please consult your medical provider/treatment team before utilizing this skill.

I - Intense Exercise (or Movement) helps to relieve some of the pent of energy by physically moving the body. Try push ups, jumping jacks, or going for a run! It doesn’t have to be for an extended amount of time. You can do this skill in bursts of 30-60 seconds.

P - Paced Breathing refers to a specific rhythm and count to the breathing. Depending on your comfort level and lung capacity, you can play around with the counts. Whatever your counts are, it is recommended to strive for a longer exhalation or out breath. For example, if you’re inhaling for 3-4 counts, trying to exhale for 6-8 counts (hello, Parasympathetic Nervous System!).

P - Paired Muscle Relaxation, or Progressive Muscle Relaxation, refers to creating and releasing tension systematically in different muscle groups. I recommend starting out with practicing clench/unclench the fists, raising/lowering the shoulders, and pointing/flexing your toes. You can also pair creating tension with an inhale. Then, release the tension on an exhale.

Remember, do not move into physical pain when doing this exercise.

Want to hear more about the DBT TIPP skills? Check out this free video from DBT-RU to hear more! (2)


(1) Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed., p. 420). The Guilford Press.

(2) [@DBTRU]. (2020, December 8). TIP  [Video]. YouTube. https://www.youtube.com/watch?v=UuvH_j9O0f4

Reminder: these blog posts are meant to be purely educational and/or entertainment tools and do NOT replace psychotherapy and/or other medically necessary treatments.

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